Individual provider Active NPI

Andronica Wiggins, NP

  • Family Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1629470125
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN165716 Issued in GA
Practice address
2200 Medical Center Blvd Ste 200
Lawrenceville, GA 30046-7765
Phone
(404) 962-6000
Fax
(404) 962-6001
NPI assigned
Sep 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN165716 GA Primary

Addresses

Primary practice location

2200 Medical Center Blvd Ste 200
Lawrenceville, GA 30046-7765

Mailing address

2200 Medical Center Blvd Ste 200
Lawrenceville, GA 30046-7765
Phone (404) 962-6000

Other identifiers 2

IdentifierTypeStateIssuer
003154983CMedicaidGA
003154983AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150327002241 GA Practitioner - Nurse Practitioner 9335466457 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Cardiovascular Professional Services, LLCGroup PAC ID 9739189838, 143 clinicians

Practice addresses (Care Compare)

1000 Medical Ctr Blvd
Lawrenceville, GA 30046-7694
Phone (678) 312-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Cardiovascular Professional Services, LLC CurrentSince Jun 29, 2025 Accepting new patients
North Atlanta Professional Services LLC CurrentSince Jan 1, 2021 Accepting new patients
Northside Surgical Professional Services LLC CurrentSince Nov 29, 2014 Accepting new patients

Locations

980 Sanders Rd
Ste 100
Cumming, GA 30041
Phone (770) 866-1074

1200 Northside Forsyth Dr
Cumming, GA 30041
Phone (770) 292-4806

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

2200 Medical Center Blvd
Ste 200
Lawrenceville, GA 30046

1285 Upper Hembree Rd
Roswell, GA 30076
Phone (770) 343-8565

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

980 Johnson Fy Rd NE
Ste 1040
Sandy Springs, GA 30342
Phone (404) 843-2721

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1629470125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 MEDICAL CENTER BLVD STE 200",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467765",
            "telephone_number": "404-962-6000",
            "fax_number": "404-962-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 MEDICAL CENTER BLVD STE 200",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467765",
            "telephone_number": "404-962-6000",
            "fax_number": "404-962-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGGINS",
        "first_name": "ANDRONICA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-16",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN165716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003154983C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003154983A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.